Skip to page contentSkip to footer

People who have had a stroke may have problems with their bowels. These problems occur because the stroke has damaged the part of the brain that controls bowel function. Some patients have trouble passing stool. Others report bowel movements that were once like clockwork, now come few and far between. Still others report having lost control over bowel movements. Each of these problems can cause distress and discomfort.

Constipation

A person is constipated when they have trouble passing their bowel movements or they are not having bowel movements as often as they need to. Constipation can cause hemorrhoid pain. It can also lead to hard-packed stool that is so hard to pass a person needs help with getting the stool out of the rectum. It is worth taking steps to avoid it.

Causes 

  • Not enough fiber in the diet

  • Eating hurried meals and having meals at odd times

  • Not drinking enough fluids

  • Not enough physical activity

  • Pain medicine

  • Antacids that contain aluminum and calcium

  • Antidepressant medicine

  • Depression

  • Drinking too much caffeine and alcohol 

  • Ignoring the urge to have a bowel movement

Treatment for Constipation

There are many options for treatment. 

  • Diet/Fluids: Eat high fiber foods. Fruits, vegetables, whole grain breads, cereals, bran cereals, wheat germ, beans are some foods that are high in fiber. Drink 8 – 10 glasses of fluids every day. Fluids may include water, fruit juice, and vegetable juice.

  • Activity: aim for activity every day or every other day

  • Bathroom habits: Go to the bathroom if you feel the urge to have a bowel movement. Do not ignore the urge. Sit upright on the commode or toilet if able. Sitting upright makes it easier to have a bowel movement.

  • Medicine: Review your medicines with the doctor. Some can cause constipation. Stool softeners, laxatives, or enemas may be needed. 

Always talk to your doctor before using any of these treatments.

Fecal Impaction

This occurs when a large, hard, dry mass of stool stays in the rectum and cannot be passed out of the body. It is most often caused by chronic constipation. Watery stool may leak out around the stool mass causing soiling of clothing. A fecal impaction will need medical care. If you have the symptoms described below, you must call the doctor.

Symptoms of Fecal Impaction

You may have watery stool if you have not been able to pass a hard stool. Some feel pain or have an uneasy feeling in their gut. You could have bloating or swelling, an upset stomach or throw up, lose interest in food, or notice weight loss or headaches. You might also feel a constant urge to have a bowel movement.

Treatment of Fecal Impaction

A doctor or nurse may need to remove the stool from the rectum. A bowel program will also be ordered by the doctor to prevent further problems.

Loss of Bowel Control (Fecal Incontinence)

Sometimes people who are having soft or normal stools lose the control over bowel movements. You may feel the urge to have a bowel movement, but you may not be able to hold it until you get to a toilet or commode. 

Reasons for Loss of Bowel Control

  • Constipation

  • Fecal impaction

  • Chronic use of laxatives

  • Diarrhea

  • You just cannot get to a toilet or commode fast enough when there is the urge to have a bowel movement 

  • Loss of strength and tone of the anal sphincter

  • Nerve damage to the anal sphincter or the nerves that sense stool in the rectum

Treatment for Loss of Bowel Control

First, tell your doctor if you are having bowel accidents.

  • Diet/Fluids: Eat high fiber foods. Fruits, vegetables, whole grain breads, cereals, bran cereals, wheat germ, beans are some foods that are high in fiber. Drink 8 – 10 glasses of fluids every day. Fluids may include water, fruit juice, and vegetable juice.

  • Activity: aim for activity every day or every other day. Also do pelvic floor exercises to improve the strength of the anal muscle. Contract the rectal muscles 15 to 20 times, three times each day. 

  • Bathroom habits: Go to the bathroom if you feel the urge to have a bowel movement. Do not ignore the urge. If it is hard for you to move around by yourself, perhaps it is worth getting a commode in your room. Sit upright on the commode or toilet if you are able. Sitting upright makes it easier to have a bowel movement. Incontinence pads may be worn to prevent soiling of clothes.

  • Medicine: Review your medicines with the doctor. Some can cause diarrhea or constipation which can cause loss of bowel control. Stool softeners, laxatives, or medicine to prevent diarrhea may be needed to treat the loss of bowel control. Always talk to your doctor before taking any of these.